Nearly 800 people have died from COVID-19 in Wisconsin. Here's what we are learning so far.

More than 100 days have passed since Wisconsin recorded its first three coronavirus deaths on March 19, and in that time the new disease has claimed nearly 800 lives in more than half the state's counties.

Much has changed in those three months: Stay-home restrictions were put in place and extended, then loosened, and suddenly set aside in many places by the state Supreme Court. There have been elections and protests.

Amid the deaths from COVID-19, experts are seeing something that hasn't happened in the state in decades.

"Halfway through 2020, 786 people in Wisconsin died prematurely, unexpectedly, and separated from family," said Ajay Sethi, associate professor of population health sciences at the University of Wisconsin-Madison. "COVID-19 will be a leading cause of death in Wisconsin for 2020. We have not had a new leading cause of death in Wisconsin or the U.S. since HIV/AIDS."

Over the past week, the numbers of positive tests and the percentage of tests with positive results are both trending up, though not spiking as in other states. 

In Dane County, the increase appears to be largely driven by people in their 20s. Few in that age group are dying of COVID-19, less than 1% in Wisconsin. So this increase may not affect Wisconsin's hospitalization or death numbers in the future, but experts are watching the trends and note that not all the case growth is among younger people.

Also, while younger adults may not get seriously ill, some do and also have died. Eight people under the age of 30 have died in Wisconsin of the virus as of Thursday, according to state figures. Younger people may also spread the virus to someone more vulnerable, experts note.

With all the developments since March, what has stayed mostly the same are the trends emerging from state data and a spreadsheet created by the Milwaukee Journal Sentinel to track Wisconsin deaths from COVID-19.

The virus is particularly deadly for men in Wisconsin and those in their mid-70s or older.

Most striking in the data, as it was when deaths hit 400 in Wisconsin, is how many people who died suffered from at least one, and often more than one, serious underlying health condition. Such conditions, whatever a person's age, makes them more susceptible to serious complications or death from COVID-19, according to the Centers for Disease Control and Prevention.

It is important to note such conditions are not unusual. In fact, more than half the population suffers from at least one of the risk-factor health conditions. Also, there is a small but growing number of cases in which the person who died didn't have a condition cited.

As the state nears 800 coronavirus deaths, many of the trends that emerged early on with COVID-19 deaths in Wisconsin have continued:

• The median age of those who have died is 76, according to the detailed cases in the Journal Sentinel spreadsheet. Among the 793 total deaths in the state, 560 were among people 70 and older, as of Thursday. That's 70% of all the deaths.
• Men account for 54% of Wisconsin’s COVID-19 deaths. When it comes to positive tests, the breakdown is almost even between men and women. While more men are dying from the coronavirus than women, this ratio isn't much different from Wisconsin's male-female death proportion when factoring in all causes, one expert said.
• For the deaths in which the Journal Sentinel has detailed information, the most common underlying conditions were heart disease, high blood pressure, diabetes, pulmonary disease, obesity and kidney failure. Heart disease includes conditions such as congestive heart failure and coronary artery disease. Dementia was also present in many cases, but it was rarely the only condition. 
• Statewide, 40 people under the age of 50 have died of COVID-19, as of Thursday. The Journal Sentinel has detailed information on 27 of these cases, and all but five had underlying health conditions listed. Three didn’t have previous health information listed, and two men — 45 and 49 years old — had no known underlying health conditions. The youngest victim was 21 and had cancer. The most common underlying health conditions in this group were obesity and diabetes.
• Of the Journal Sentinel’s collected data, 11 victims of COVID-19 had no underlying health conditions listed. All but two of those 11 people were 64 and older. 
• At least 43% of COVID-19 victims were living in nursing homes or assisted living facilities, according to state data.
• Looking at only Milwaukee County data gathered by the Journal Sentinel, about 43% of those who died of coronavirus complications were white, 40% were Black and 13% were Hispanic. The county’s population is 27% Black and 16% Hispanic or Latino. 
• Across all of Wisconsin, 69% of COVID-19 victims were listed as white and 23% were listed as Black. The white category also included people who are Latino, a group that also accounted for 11% of statewide deaths.
• In Wisconsin, 3% of those who tested positive have died of the coronavirus. However, the actual percentage is likely smaller because some people with mild or no symptoms would test positive if there was greater testing capacity, experts say. 
• The rate of COVID-19 deaths statewide appears to have slowed in the past month since Wisconsin had its highest number of deaths in a single day on May 27. In recent weeks, most days deaths have been in the upper single digits. No deaths were reported on a handful of recent days, while on a few others the state saw more than 10.
• People have died of coronavirus complications in 44 of Wisconsin’s 72 counties. The counties with higher numbers of deaths, such as Milwaukee, Racine, Kenosha and Brown, are more populous. Milwaukee County's 391 reported deaths account for nearly half the statewide total as of Thursday.

Outlook 'still complex' 

Wisconsin's trends are in line with what is happening nationally and globally with older people with underlying health conditions being most vulnerable, said Sethi, the UW-Madison professor.

He noted, though, that Wisconsin's recent trend upward in positive cases is occurring in "a very different context" from the early days of the pandemic, when little was known about the virus. While problems such as outbreaks in nursing homes still persist, more knowledge about how COVID-19 is spread has prompted people to take precautions to protect themselves and others.

If those who are more at risk for COVID-19 are being proactive about keeping healthy, Sethi said it's possible Wisconsin won't see a rise in hospitalizations or deaths for several weeks. 

He also pointed out that 20-somethings weren't the only new cases reported last week. People of all ages are interacting in Wisconsin's reopened communities, Sethi wrote in an email, noting, "The dynamics are different but still complex." 

He also cautioned that younger people are more likely to have an asymptomatic case of COVID-19 or be unaware of underlying health conditions.

CDC finds commonalities in deaths 

The conditions found in Wisconsin deaths match risk factors for serious complications and death from COVID-19 reported by the Centers for Disease Control and Prevention.

Besides older adults, people of any age with the following conditions are at increased risk of severe illness from COVID-19: diabetes, chronic kidney disease, lung disease, heart problems, weakened immune systems and obesity among ailments.

Because COVID is so new, public health officials said they are still trying to determine all the conditions that make people most vulnerable. Other factors that may increase risk include: asthma, high blood pressure, pregnancy and smoking.

Even with the growing toll, there have been reports indicating that not everyone dying from COVID-19 is ending up in official counts.

At the same time, doctors and pathologists say they need to examine each case closely. An average of 140 to 150 people die each day around this time of year in Wisconsin, and it will be important to determine just which deaths are caused by COVID-19, experts say.

In Milwaukee County, the medical examiner is reviewing every case suspected of being caused by COVID-19. The office has handled 19 cases of people who died and tested positive for COVID-19 but the cause of death was not from the virus. The causes included death from falls, heart disease and stroke, records show.

Researchers will be studying if the COVID pandemic may be "pulling deaths from the future," hastening the deaths of people who were nearing death, though that will be not evident for several months.

There is an indication that may be happening to some degree in Milwaukee County during the COVID-19 pandemic, but the evidence of that is becoming less convincing.

Between March 1 and April 29 of this year, there were 30% fewer natural deaths compared with the same time last year, suggesting that COVID-19 may be claiming people who would be dying anyway, according to the medical examiner's office.

But that gap has closed during the past two months. As of June 30, there were 7% fewer natural deaths for the year compared with the same time last year, according to the office.

Officials will be watching closely to see if that gap closes further through the summer and into fall.